Search

Background: Excessive use of broad-spectrum antibiotics in hospitals has led to the emergence of highly resistant strains of Pseudomonas aeruginosa. The main mechanism of resistance of this bacterium to fluoroquinolones and carbapenems are the modification of type II topoisomerases (DNA gyrase and topoisomerase IV) and alterations in the OprD porin, respectively. The aim of this study was to examine for the occurrence of mutations related to fluoroquinolone resistance of gyrA and parC genes and mutational inactivation of oprD gene of clinical isolates using DNA sequencing technique. Methods: A total of 60 P. aeruginosa isolates were collected from the hospitalized patients in the Intensive Care Units (ICUs) of Al-Zahra hospital located in Isfahan, Iran. The pattern of sensitivity to antibiotics was determined using CLSI disk diffusion and MIC methods. The assay was based on a DNA sequencing method using polymerase chain reaction (PCR) for amplification and sequencing of t h e selected genes. Results: The results show that replacement of Ile for Thr-83 in gyrA was the only replacement, while other substitutions not observed. No mutations were found in parC. The most frequent amino acid alterations were E185Q, P186G, and V189T, found in five resistance isolates, However, nucleotide insertions and deletions mutations not observed. Conclusion: Our study suggested that mutation of gyrA and oprD genes may play a minor role in fluoroquinolone and carbapenem resistance and other mechanisms may contribute to the fluoroquinolone and carbapenem resistance of P. aeruginosa. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this pilot study was to determine whether the MRI and biomarkers human epididymis protein 4 (HE4) and CA125 correlate with depth of myometrial invasion, histologic grade, cervical involvement and nodal metastases in patients with endometrioid adenocarcinoma of the uterus. Materials and methods: This was a prospective, observational study in women with biopsy-proven endometrial adenocarcinoma of the uterus. Preoperative pelvic MRI was performed and concentration of HE4 and CA125 were assessed before surgery. All surgical specimens were reviewed by a single expert pathologist. The results were compared with the final histopathology report of surgical staging. Results: Included were a total of 68 women with endometrioid adenocarcinoma of the uterus, most (76%) with stage I disease. Levels of serum HE4 greater than 140PM and CA125 greater than 35 ku/L were observed in 12 (17%) and 26 (38.2%) of patients respectively whose greater proportion were cases with deep myometrial invasion and high grade tumor. In the evaluation of deep tumoral invasion (> 50%) of the myometrium sensitivity, specificity, and diagnostic accuracy of MRI were 68.9%, 94.8% and 83.8% respectively. For lymph node involvement these values were 50%, 95.1% and 91.1% respectively and for cervical stromal involvement were 64.3%, 98.1% and 91.1% respectively. Conclusion: Higher stage, deep myometrial invasion, and lymph node or cervical stromal involvement increase diagnostic accuracy of MRI. Higher levels of HE4 and CA125 were observed in patients with deep myometrial invasion and higher grade of tumor. [ABSTRACT FROM AUTHOR]